IL-8 and pH Values in Exhaled Condensate after Antibiotics in Cystic Fibrosis Children

Abstract

Interleukin (IL)-8 is a major factor in inflammatory response and the IL-8 levels in exhaled breath condensate (EBC) may be used as a marker of airway inflammation. Airway acidification is implicated in the pathophysiology of obstructive airway diseases and pH EBC values have been used as a marker of airway acidification. The aim of our study is to investigate whether IL-8 and pH levels in EBC of cystic fibrosis (CF) children with respiratory exacerbations change after antibiotic treatment. Lung function, IL-8 and pH EBC values were measured in fifteen CF children (mean age 11 years) with acute exacerbation before (T0) and after two weeks (T1) of antibiotic treatment. IL-8 and pH values were compared by paired t-test. A p<0.05 was considered significant. IL-8 EBC levels decreased after antibiotic treatment (TO 0.36±0.03pg/ml vs T1 0.28±0.03pg/ml; p=0.03) and pH values increased (TO 7.3610.09 vs T1 7.61±0.08; p=0.04). Results suggest possible application of EBC as a non-invasive tool to monitor efficacy of antibiotic treatment in CF patients.

Elevated expression of both mRNA and protein levels of IL-17A in sputum of stable Cystic Fibrosis patients

“…This is in contrast with findings of Sagel et al, who demonstrated that the presence of both P. aeruginosa and S. aureus had an additive effect on concentrations of inflammatory markers in BAL [22]. Bodini et al showed that leukotriene B4 (LTB4) and IL-8 levels in exhaled breath condensate were also related to the type of bacterial infection in CF patients, with highest levels in CF patients infected by P. aeruginosa [23]. P. aeruginosa might stimulate the IL-17A/IL-23 axis in the airways via activation of Toll like receptor (TLR) 4, similar to gram negative Klebsiella pneumonia [24], while peptidoglycans and bacterial lipoproteins from Gram-positive bacteria such as S. aureus mediate their response trough TLR2.…”

Biomarkers for differentiation of causes of respiratory distress in dogs and cats: Part 2 – Lower airway, thromboembolic, and inflammatory diseases

“…Children with cystic fibrosis have higher concentrations of EBC IL‐8 . The EBC IL‐8 levels were clinically useful in this patient population, in that they increased further with pulmonary bacterial colonization and improved with antibiotic therapy . Mechanical ventilation was associated with increases of IL‐1β, IL‐6, and TNF‐α .…”

“…There are numerous cytokines involved with inflammation and their role in various disease processes is currently under investigation . Cytokines have been evaluated in EBC in numerous disease conditions in people . Human asthmatics have increased IL‐4 and TNF‐α and decreased IFN‐γ .…”

Treatment of pulmonary exacerbations in cystic fibrosis

“…During a pulmonary exacerbation, there is increased expression of some markers of inflammation and/or lung damage, for example C-reactive protein, white cell counts, interleukin-8, neutrophil elastase alpha 1-antiprotease complexes [15][16][17] and matrix metalloproteins [18], in blood or serum. Circulating markers may not truly reflect the local inflammatory response in the lung; however, this can be examined by measuring the sputum concentrations of bioactive lipid mediators, such as the cysteinyl leukotrienes and prostaglandin-E2 [19], or sputum cell counts [16] or analysing exhaled breath [20][21][22] or urine [23] during exacerbations. However, none of these are routinely used in clinical practice.…”